Clinical and Medical Investigations

In December 2019 a novel RNA beta-corona virus, highly contagious, was recognized to be the cause of previously pneumonia cases of unknown origin.The virus is phylo-genetically similar to SARS-CoV and has been called SARS-CoV-2 (COVID-19).Most common is the emerging of a strong dys-regulation of the immune response, that leads to disease severity in COVID-19 patients.There are a lot of suggestions indicating that mortality, strong in critically ill patients, might be correlated with virally driven hyper-inflammation, due to a cytokine storm.Interleukin-6 (IL-6) plays an important role in cytokine release syndrome and elevated IL-6 level is a hallmark inflammatory signature seen in serum of patients with severe COVID-19 acute respiratory distress (ARDS).We analyzed blood inflammation indicators, IL-6 and its receptor complex and TNF-α, in order to demonstrate that cytokines unbalanced systems can be considered an early tool to identify critical patients and to predict their poor prognosis.Our study was conducted on N=23 critically patients with confirmed COVID-19 and admitted in Intensive Care Unit (ICU) from March 10 to April 30 due to severe respiratory failure.Serum levels of IL-6, sIL-6R, sgp130 and TNF-α were determined using CLIA and ELISA as immunoassay.Our data shown that not all patients have higher values in serum of sIL-6R agonist receptor, compared to the controls.For this reason we have stratified all patients in two different group (1 and 2).We observed that in GROUP 1 as well as in GROUP 2 the IL-6 and TNF-α serum levels are significantly increased in respect to the controls.Despite, sgp130 antagonist receptor levels are significantly decreased in all patients.Further studies are required to better investigate the role of IL-6 and its soluble receptor complex during COVID-19 disease and to evaluate the possible involvement of other cytokines also in response to different pharmacological treatment.

During the present public health emergency caused by COVID-19 spreading rapidly worldwide, the focus is mainly on containing the epidemic to provide relief to hospitals meeting unprecedented demands.Primary care physicians, especially in low-and middle-income countries, are therefore now frequently requesting advice on how to treat their COVID-19 patients at home in the early phase of the disease.Here, we provide recommendations for treating the illness at home, based on the pharmacological rationale and the available clinical evidence of efficacy in COVID-19 patients, including results from published clinical trials, for each recommended class of drugs.Moreover, we have drawn on the experiences of one of us who has used his extensive background in the field of infectious diseases, as well as common sense, to treat COVID-19 patients at home.

People have probably used plant-based substances to improve their appearance since the existence of mankind.The first documented use of cosmetics dates back to 3,000 BC from ancient Egypt, but it is safe to say that this custom has been (and still is) an integral part of daily life in all civilizations.The initial use of plantderived makeup -sometimes supplemented with paints and dyes -has come full circle and is back with the contemporary trend of using beauty products that are mainly derived from plant sources.The Republic of Suriname (South America) is renowned for its extensive ethnopharmacological knowledge and unique plant biodiversity that provides ample raw material that can be processed into cosmetics and cosmeceuticals.This paper gives some historical highlights on the use of makeup throughout the world with the emphasis on naturally-derived products; focuses on the herbal cosmetics industry in Suriname; extensively addresses the scientific rationale for incorporating extracts from plants in cosmetics and cosmeceuticals in the country; and concludes with the conditions to establish a beauty products industry in Suriname.

Family-centered care (FCC) approach acknowledges that the family has the greatest influence over an infant's / child's health and well-being.Assessing the FMs' needs is an important component to apply and improve family-centered care, and it is essential for pediatric nurses in the intensive care units to identify and understand these needs.Meeting the needs of family having neonate or child in intensive care is part of implementing the philosophy of family-centered care.Aim of the study is to explore nurses', doctors' and parents' perceptions on family needs in pediatric critical care units at King Khaled Hospital in Jeddah.Methodology: Exploratory and descriptive design was used.doctors, nurses and parents from Pediatric Critical Care Units at King Khalid Hospital, Jeddah participated in the study using non-probability convenient sampling technique.Critical Care Family Needs Inventory (CCFNI) a tool developed by Jane Leske was used for assessing nurses', doctors', and parents' perceptions on family needs.The original English version was translated into Arabic by qualified English to Arabic translator.Validity was tested by Arabic faculty staff members and subjected to a pilot test to test for its validity within this context Reliability of the CCFNI was 0.97 by.Gundo.

Backgrounds: Tuberculosis (TB) is a major public health problem in Sudan and in many African countries.The objective of this study is to provide health authorities and patients with insight into the perceived factors affecting TB treatment default.Methods: The data was collected by means of focus group discussions (FGD).Six FGD were conducted (3 for defaulted patients and 3 for health personnel).Overall, 27 TB defaulted patients and 24 health care providers were randomly selected.Results: Participants reported that lack of knowledge about TB, high cost of transportation, difficulty for making a daily visit to health facilities for DOT programme due to distance of the facilities from their residences, rural residency, social circumstances, TB-related stigma, lack of family support, patient movement or giving wrong address, seeking traditional healers and treatment-related factors such as side-effects of drugs, the attitude of health care providers, the long delay in obtaining medications, and weakness and challenges facing defaulter tracing teams.There were consistent findings from interviews among patients and health care providers. Conclusions:The study revealed several challenges and barriers leading to TB treatment default.Our findings may help in improving interaction between patients, families, health personnel and policy makers.

Amikacin spectrum of activity is the broadest of all aminoglycosides.Amikacin is active against most strains of Serratia, Proteus, and Pseudomonas aeruginosa as well as most strains of Klebsiella, Enterobacter, and Escherichia coli that are resistant to gentamicin and tobramycin and is rapidly bactericidal.Amikacin doses are 15 mg/kg once-daily, and 7.5 mg/kg twice-daily in infants, and 20 to 40 mg/kg once-daily in children.Amikacin is preferentially administered once-daily, because yields lower though and higher peak concentrations, thus reducing the risks of toxicity, and increases peak concentration, thus improving therapeutic efficacy.Amikacin is absorbed rapidly after intramuscular injection; its peak plasma concentration is 20 µg/ml after an injection of 7.5 mg/kg.Amikacin mean half-lives are 6.0 hours in infants in the first weeks of life, and 1.9 hours in children aged up to 6 years.Amikacin causes limited ototoxicity and nephrotoxicity in infants and children.After a single intramuscular amikacin dose of 7.5 mg/kg, its concentration (µg/ml) is 14.9 in serum, 2.2 in skeletal muscle, and 1.9 in fat tissue.Because of its polar nature, amikacin penetrates poorly into the cerebrospinal fluid, and serum peak to amniotic fluid ratio is 0.03.Amikacin pharmacokinetics have been extensively studied in infants and children and pharmacokinetic parameters vary remarkably.Half-life and clearance decreases and increases, respectively, during infant maturation.Burn, cancer and renal impairment have an important impact on pharmacokinetics.Some bacteria may become resistant to amikacin.The aim of this study is to review the published data on amikacin effects, metabolism, pharmacokinetics, and bacteria-resistance in infants and children.

Cardiomyopathies are a major cause of heart failure and one of the leading indication for cardiac transplantation.Hypertrophic cardiomyopathy (HCM) is the second most frequently encountered phenotype of cardiomyopathy in clinical practice after dilated cardiomyopathy (DCM).Early identification and prompt treatment of patients with HCM at increased risk of death is imperative in clinical management.Thus, this article aggregates available research-based evidence to provide a comprehensive review of HCM.The goal is to advance the knowledge and understanding of HCM and improve its diagnosis and management.The review is organized into eleven main sections.The initial sections introduce and define HCM, review forms of HCM, its epidemiology (risk and prevalence rates in defined populations), clinical signs and symptoms, prognosis and risk markers.The latter sections review the pathophysiology of HCM, the etiologic agents, differential diagnosis and clinical management of HCM.The review also includes a meta-analysis of diagnostic and clinical management methods.

The un-precedent down of corona pandemic and increments worldwide human death rates as well as thousands of diseased human subjects leaves tiny room for researchers to think about the real origin of Sars-cov-2.Where it comes from.The notable enormous tasks were mainly in two directions.First the search for promising vaccine technology saving human life pre-epidemic and during epidemics.The second, however, was centered around search for valid safe chemotherapeutics for saving life of the individual cases.The present communication aims at through a light on the current vaccine race, vaccine immunity and vaccine herd immunity.Governments, vaccine technologists, health science workers are being in a conquer to win the race and being the forerunners in manufacturing immune protective sars-cov-2 human vaccine.To date the in hand prepared vaccines are investigational in preclinical developmental phases and few of which reaching Phase I clinical trial.These scientific bodies and companies propose reach deadline vaccine development and production ranged from 9 up 18 months, though the scientific logic predict at least two to three years for that deadline.

During the present public health emergency caused by COVID-19 spreading rapidly worldwide, the focus is mainly on containing the epidemic to provide relief to hospitals meeting unprecedented demands.Primary care physicians, especially in low-and middle-income countries, are therefore now frequently requesting advice on how to treat their COVID-19 patients at home in the early phase of the disease.Here, we provide recommendations for treating the illness at home, based on the pharmacological rationale and the available clinical evidence of efficacy in COVID-19 patients, including results from published clinical trials, for each recommended class of drugs.Moreover, we have drawn on the experiences of one of us who has used his extensive background in the field of infectious diseases, as well as common sense, to treat COVID-19 patients at home.

Objective: This cross-sectional study investigated the difference in association between cardiovascular prognostic markers and one-year mortality in a population with heart failure and followed outpatient.Method: The data were collected in the medical files of the patients followed in therapeutic unit of heart failure of the hospital of Gonesse in the northeastern region of Paris.The associative method chosen between markers and mortality was the Odd Ratio.The markers most strongly associated with mortality were adjusted to the other co-variables retained.Results: Pro BNP association with mortality emerged predominant.Then were age and clearance as variables strongly associated with mortality.The Pro BNP adjustment to clearance suggested a strong positive interaction between these two variables.Conclusion: These interesting results were obtained on a small sample in cross-sectional analysis, it would be interesting to compare them to a prospective analysis.

Acute necrotizing encephalopathy of childhood (ANEC) is a disease characterized by respiratory or gastrointestinal infection and high fever accompanying with rapid alteration of consciousness and seizures.We report a classic case with characteristic imaging findings on MRI which is crucial in diagnosing and of prognostic importance.